Assessment of normal and abnormal prosthetic mitral valves by Doppler echocardiography. Doppler in prosthetic mitral valves.
Pulsed, continuous-wave, and color Doppler were performed in 165 normal mitral prostheses and 58 patients with prosthetic dysfunction (46 regurgitant and 12 obstructive valves) proved by catheterization and/or surgery. Mean mitral gradient (MG) and pressure half-time (PHT) were determined in all cases. Among normal prostheses, a wide range of both MG and PHT was observed in each type of valve and a considerable overlap between valves of different size. St-Jude's valve had the most optimal hemodynamics. Mild mitral insufficiency was detected in 14% of tissue and 24% of mechanical mitral valves. Repeat studies were performed in 30 patients over a 2.4 years period. Nine patients developed Doppler evidence of new prosthetic dysfunction, while Doppler parameters remained unchanged in 21 patients during the follow-up period. Among malfunctioning valves, Doppler correctly identified all cases of prosthetic obstruction (n = 12), and 42 of 46 regurgitant valves. We conclude that Doppler echocardiography is a very useful technique in both non-invasive assessment and follow-up of normal prosthetic valves in the mitral position and in detecting prosthetic dysfunction, especially when prosthetic obstruction is present.
Habib
G
G
Department of Cardiology, La Timone Hospital, Marseille, France.
Benichou
M
M
Bonnet
J L
JL
Jau
P
P
Bille
J
J
Djiane
P
P
Luccioni
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D004868:Equipment Failure; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology* / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis; D012086:Reoperation; D013927:Thrombosis / Q000175:diagnosis